A review of shoulder replacement surgery.

Shoulder replacement surgery is employed in the treatment of severe shoulder arthritis and following some proximal humeral fractures. Three different replacements are available: hemiarthroplasty (HAS), total shoulder replacement (TSR) and reverse shoulder replacement (RSR). HAS and TSR are indicated in patients with intact rotator cuffs and RSR for cuff deficient older patients. Outcomes are favourable, with the majority of patients having improvements in shoulder pain and function.

Tourette disorder: a cross-cultural review.

Tourette's disorder (TD) is a complex disorder of motor and vocal tics starting in childhood or adolescence. Although the disorder has been researched extensively in North America and Europe, clinical features and associated conditions of TD are less well known in other cultures. The English-language literature relating to TD was searched for cross-cultural case reports, clinical investigations, and epidemiological studies, and the subsequent database was analyzed. The clinical characteristics of TD displayed a strong similarity across cultures. Demography, family history, clinical features, associated conditions, comorbidity, and treatment outcome were essentially the same in the various cultures investigated. The disorder appears world-wide, has similar clinical characteristics, and most likely has an underlying biological and genetic basis.

Tourette syndrome: a psychoeducational presentation.

Tourette Syndrome (TS) is a neurological disorder with onset prior to age 21. The wide range of difficulties associated with TS present significant barriers to both the positive school functioning of students with TS and the ability of their teachers and peers to cope with the sometimes difficult classroom behavior which results from this syndrome. Since TS children with teachers knowledgeable about TS and its effects on learning fare better than those whose teachers are not knowledgeable, dissemination of this information to school personnel is crucial. Health teaching is a significant contribution within the nursing role. In order to ameliorate some of the stressors and academic problems experienced by children and adolescents with TS, the TS Clinic of St. Boniface General Hospital is composed of a multidisciplinary team whose mandate includes the provision of educational awareness audiovisual presentations to schools and the general community throughout Manitoba. This presentation will include the historical, psychosocial, educational, symptomatological, and treatment aspects of TS.

Tourette syndrome: associated symptoms and most disabling features.

Four hundred forty-six patients with Tourette Syndrome (TS) and/or their parents completed a 52-item self-report survey about vocal and motor tics, and the frequency of associated co-morbid conditions of aggression, obsessions and compulsions, attentional problems, sleep disturbance, mood disturbance, anxiety, and self-mutilative behaviours which have been frequently reported in the literature on TS. Respondents also responded to an open-ended question regarding the most disabling aspects of TS. Results were analyzed within two age groups; under 18 years of age (N = 245) and 18 years of age or older (N = 177). Tics and associated conditions were the most frequently reported disabling aspect by both age groups. Subjects under age 18, however, reported significantly more frequent problems with hyperactivity, temper control, aggressive behaviours and sleepwalking than adults with TS.

Tourette syndrome: issues in diagnosis.

Information was accumulated by self-report questionnaire from 462 Canadian Tourette syndrome (TS) patients. The mean age of onset of the syndrome was 7.4 years, while the mean age of medical diagnosis was 15.2 years, suggesting that the mean lag between onset of symptoms and diagnosis was 7.8 years. Seventy-three percent of patients reported initial misdiagnosis by physicians and only 33% of the patients reported receiving their first information about TS from physicians. Respondents indicated that they were typically diagnosed as having Attention Deficit Disorder, Hyperactivity, or Minimal Brain Dysfunction prior to the establishment of the TS diagnosis. Factors involved in the delay in physician diagnosis of the syndrome, as well as the association between TS and other neuropsychiatric disorders, are also discussed.

Bone regeneration and tissue acceptance of human fascia lata grafts adjacent to dental implants: a preliminary case report.

The biologic principle of guided tissue regeneration (GTR) has been studied extensively in hopes of regenerating alveolar bone. Various materials have been utilized as regenerative membranes; however, all materials have disadvantages, and the ideal membrane material is yet to be identified. In this case report, human freeze-dried fascia lata strips were used as a regenerative barrier membrane in conjunction with the placement of endosseous root implants and demineralized, freeze-dried bone allograft. The major advantage in the use of human fascia lata for guided tissue regeneration is that a second procedure to remove the material is not necessary, and the fascia is accepted by the surrounding tissues without complication. There is acceptance of four endosseous root-form dental implants that were immediately placed into fresh extraction sockets and covered with demineralized freeze-dried bone allograft (DFDBA), with human freeze-dried fascia lata used to serve as a biocompatible, collagenous, regenerative augmentation membrane over the dental implants. The biologic concept of GTR is clinically applied to increase the dimensions of the edentulous, maxillary alveolar ridge with use of human freeze-dried fascia lata barrier membranes.

Tourette syndrome: impact on Canadian family functioning.

An evaluation of the impact of Tourette Syndrome on the family. Self-report data were gathered from a Canadian sample of over two hundred Tourette Syndrome patients and/or their families regarding the effects of TS on family life. Patients rated the extent to which having TS interfered with the family's day-to-day activities. Also indicated was whether marital difficulties or difficulties with alcohol or drugs arose since the Tourette diagnosis was made. Data were also gathered on the number of TS patients or other family members who sought professional counselling and the extent to which counselling was found helpful.

Tourette syndrome and medical treatment in Canada.

Self-report data were gathered from a national sample of over two hundred Canadian Tourette Syndrome (TS) patients. Included was previous use of stimulant medication and prior extended use of antihistamines for allergies or sinus condition. Patients were also asked information on Tourette Syndrome-precipitated hospitalization or boarding school placement, the type of physician treating them and on a five-point scale their level of satisfaction with their medical care. Results indicate that over 20% of TS patients have used stimulant medications and 30% have used antihistamine for extended periods. Many patients have spent time in psychiatric settings and most are under the care of psychiatrist or neurologist. Approximately 40% of TS patients reported being satisfied to very satisfied with the medical care they were receiving, and 20% having mixed feelings. Few patients receiving medical care were dissatisfied with their treatment.

Fra(2) (q13) and inv(9) (p11q12) in autism: causal relationship?

Twenty individuals with autism or related disorders underwent chromosome analysis and physical examinations with documentation of minor anomalies. Chromosome anomalies were identified in 3: 2 had the heritable folate sensitive fra(2) (q13) site and 1 had an inv(9) (p11q12). No heritable chromosome variants or anomalies were seen in 20 age and sex-matched control individuals. When patients with the fra(2) were excluded from analyses, there was no difference in the frequency of chromosome breaks and/or gaps between the study group and control group. The results of this study suggest that heritable folate sensitive fragile sites and other chromosome variants may be more commonly seen in individuals with autism or related disorders in childhood than in the general population.